Obstetrics and gynecology
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Obstetrics and gynecology · Jan 1989
Comparative StudyHysteroscopy with selective endometrial sampling compared with D&C for abnormal uterine bleeding: the value of a negative hysteroscopic view.
Hysteroscopic evaluation of 187 patients with abnormal uterine bleeding is reviewed. One hundred fifty-one patients had recent tissue sampling by a blind method. The hysteroscope with selected endometrial sampling was more accurate in 9.1% and less accurate in only 0.5% of patients. ⋯ Endometritis was the only condition missed by hysteroscopic viewing and selected biopsy. Those lesions missed by blind tissue sampling were uterine fibroids and endometrial polyps. Among 91 patients whose hysteroscopic view was negative, an abnormality was identified by tissue sampling in only one patient with endometritis.
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Obstetrics and gynecology · Jan 1989
Disseminated intravascular coagulation and the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia.
To clarify the role of disseminated intravascular coagulation (DIC) in women with the hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, serial coagulation studies were performed prospectively in 18 patients. A semiquantitative DIC scoring system was used retrospectively to augment the diagnostic confidence of coagulopathy. At the time of admission to the hospital, three patients showed no evidence of DIC, eight had suspected DIC, and seven had manifest DIC. ⋯ Patients with manifest DIC at delivery developed significantly more life-threatening maternal complications than did patients with suspected DIC (P less than .02). Conservative management was not possible in any patients who were admitted with overt DIC because of deterioration of maternal and fetal status. Application of a sensitive DIC scoring system may be valuable in managing patients with the HELLP syndrome and selecting patients who may be treated expectantly.